Social determinants of access to minimally invasive hysterectomy: Re-evaluating the relationship between race and route of hysterectomy for benign disease
American Journal of Obstetrics and Gynecology Aug 24, 2017
Price JT et al. – This study aimed to determine if access to minimally invasive hysterectomy for benign indications differs according to race, independent of the effects of appropriate subject–level confounding factors. The study also investigated the association between socioeconomic status and ethnicity and access to minimally invasive hysterectomy. The results demonstrated that although the odds of undergoing minimally invasive hysterectomy were diminished in women of Hispanic ethnicity and in those enrolled in Medicaid when accounting for the effect of pertinent demographic and clinical factors, there was no discrepancy along racial lines. However, despite availability of robotic assistance in all hospitals treating the study population, both racial and socioeconomic disparities were observed with regard to the access to robot–assisted hysterectomy. Thus, strategies pertaining to all minimally invasive routes should be explored in all women for ensuring equal access for aligning delivery of care with evidence substantiating broad implementation of these procedures as safe, cost–effective, and highly acceptable to patients.
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